Fish oil consumption and reduction of arterial disease

Fish oil consumption may help to normalize the prethrombotic state and reduce arterial disease. This antithrombotic potential of fish oil, rich in (n-3) polyunsaturated fatty acids (PUFA), has been attributed to a reduction in platelet activation, a lowering of plasma triglycerides and (vitamin K-dependent) coagulation factors and/or a decrease in vascular tone. Most intervention studies have shown only moderate effects of (n-3) PUFA on these hemostatic variables. On the other hand, the usually small prolongation in bleeding time with fish oil does not appear to lead to bruising or hemorrhage, at least in healthy subjects. This contrasts with the increased bleeding risk accompanying the more prominent antihemostatic effects of antiplatelet and anticoagulant drugs. Here we propose that the beneficial effect of (n-3) PUFA diet is related to down-regulation of the mutually positive interactions of platelet activation and coagulation. In addition, we consider the possibility that the dietary effect on hemostatic and lipid factors involves transcription regulation of multiple genes, perhaps in a subject-dependent manner. J. Nutr. 133: 657-660,2003.